SSUM Cdk Affect in Economy of Nationwide Worksheet


3 attachmentsSlide 1 of 3attachment_1attachment_1attachment_2attachment_2attachment_3attachment_3.slider-slide > img { width: 100%; display: block; }
.slider-slide > img:focus { margin: auto; }

Unformatted Attachment Preview

Determining the Degree and Factors of Economic Burden Caused by the Chronic Kidney
Disease Condition among the Populations of the Developed Countries
Student Name
1.0 Introduction
1.1 Background
1.1.1 What is CKD?
Jha et al. (2013) defines chronic kidney disease (CKD) as a reduced rate of the
glomerular filtration process or an increased excretion of urinary albumin, or can take both
conditions. But in the simplest form, CKD is the persistent disease of the kidney that if untamed
may lead to renal failure. The definition by Jha et al. (2013) implies that when the glomerular
filtration process hits its lowest rate, kidney are less likely to perform their functions optimally –
they get to filter molecules inefficiently to the point of letting larger unpermitted molecules to
pass through the glomerular. These larger molecules are also the albumin compounds that pass
through the organelle to getting CKD referred as an increase in urinary albumin excretion.
(Fiston: you need to use your own words)
CKD has become an increased public health issue across the world due to many factors
but majorly the changes of lifestyles (Ashton and Duffie, 2011). CKD has from the recent past
translated to be among the chief causes of death as well as prevalent disability-adjusted lifespan
internationally. On the other hand, awareness among the health-care attenders and their patients
is quite low, elevating the situation even more.
In a predetermined forecast, the number of CKD patients might grow at the fastest rate
among the developing countries or poor ones (Jha et al., 2013). The case condition is currently
saturated among the developed countries where approximately over 200,000 people fall by the
axe of CKD. Not that it is a new disease, but its existence has been overly ignored until recently
when national budget allocations have been laid to help curb the disease by alleviating the pain
and/or slashing the mortality rates caused by CKD. But even more surprising, there is a
significant correlation established between the low economic development levels and reduced
availability of kidney replacement intervention or therapy. Thus, the variations in approaches
applied in the estimation of creatinine concentrates in serum and albuminuria induct a negative
impact on the estimation of cases under potential or early-stage of the CKD (Coca et al., 2012).
(You will need to use quotation marks around words not your own and you have to include pages
numbers for where the citation comes in the article.)
Some unique causes of and risk factors for the CKD condition, like getting exposed to
herbal preparations and/or the environmental regimens, exist in some rural parts of the world.
Care for advanced CKD is greatly associated with non-ideal health expenditures especially in the
developing countries. The difference between the developed and developing countries in terms
of controlling the disease is all budget-centered, in a way that a focused country lays straight and
sufficient allocations, while a poor country fails to recognize the mitigation process of CKD.
To detect CKD earlier requires a management or whoever responsible for the cases to
develop cost-effective approaches that are relevant to the community levels (or local) of
economic resource and management development. Integrating screening and strategic
management for the CKD regimens into the national programs for non-communicable diseases is
potentially powerful with reduction of the burden imposed on the public by the disease as well as
cuts on the cost of its care (Palmer et al., 2008). But due to the shortage of trained and certified
nephrologists, general practitioners are called for a full initiative to care maximally for patients
with CKD. (See above comments about quoting and page references)
1.1.2 Cause, Symptoms and Management of CKD
There are two primary causes of CKD: diabetes and hypertension (or high blood
pressure). Diabetes and hypertension can cause up to 66.67% of CKD among the established and
identified cases. When the blood sugar is too high, diabetes results leading to damage of vital
organs of the human body including the heart and kidney. Diabetes can also lead to damage of
nerves, blood vessels, and eyes. While, when the pressure of the blood against walls of the blood
vessels in humans increases, the condition is known as high blood pressure. With a poorly or
uncontrolled state, high blood pressure can cause the CKD, heart attacks, and stroke. However,
CKD can also initiate high blood pressure where there existed none.
Other conditions that may cause CKD include malformations on kidney (especially in
mother’s womb when the baby is developing), glomerulonephritis (the diseases associated with
the damage or inflammation of kidney’s filtering units), lupus, repeated urinary infections, and
obstructions like tumors, kidney stones, and enlarged prostate glands.
Symptoms of CKD are:
Difficulties in concentration
Tiredness and less energy
Troubled sleep
Developing dry and itchy skin
An often urination, especially at night
Poor appetite
Muscle cramp developing at night
Eyes getting puffed in the morning, and,
Swollen feet and ankles
At the same time, one gets to risk having CKD in cases where:
They are older
They have hypertension
They belong to a diabetic prevalent population, for example, American Indians,
African Americans, and Pacific Islanders
They have diabetes
Their family history records cases of kidney failure. (Source?)
There are ten suggested ways of how to manage CKD. The patient may feel poorly most
of the times, but it does not necessarily mean that they are always doomed to have this condition.
Some ways in which they can manage the condition is by:
Stopping the smoking habit, in case the patient smoked.
Controlling the blood pressure level
Managing stress and depression appropriately
Getting enough sleep
Working closely with a dietitian or nutritionist that helps with meal planning
On diabetes case, meeting the blood glucose goal
Taking medicines as prescribed by the doctor
Having a physical activity as part of the patient’s routine
Aiming for a healthy weight (avoiding overweight and obese conditions)
Working closely with the health care worker who can monitor the kidney health.
1.1.3 The Global Statistics and Trends for CKD
According to Abd et al. (2018), death rates due to age standardizations that are caused by
CKD have risen for the past 23 years. For instance, CKD has adjusted from its 36th position list
for causes of death in 1990 to being the 19th death cause in 2013. This increase in CKD
associated with the escalated cardiovascular mortality and morbidity rates due to CKD are
estimated to reach a pandemic level in a decade to come.
The complications brought by CKD are exact representation of a considerable burden on
the global health care provision process and resources that just a few number of countries can
manage to tame through their sufficient robust economies by counteracting the challenge posed
by CKD (Abd et al., 2018). Besides, the differences in health as associated with the
socioeconomic are dominant, especially where individuals having a lower socioeconomic status
(SES). In a matter of identifiable variables, they are projected to be highly susceptible to CKD
mortality and morbidity as compared to those with higher SES (Bello et al., 2008).
Luyckx et al. (2018) established that the global burden of disease (GBD) as at 2015 was
estimated to have prevailed through the 1.2 million people who died from the kidney failure
disease, which equivalently reflected a 32% from the year 2005 (Wang et al., 2016). While in
2010, statistics has revealed that around 2.3 to 7.1 million people succumbed to end-stage kidney
disease having failed to access the chronic dialysis centers (Liyanage et al., 2016). In addition, it
is thought that about 1.7 million people globally succumb to AKI while generally, about 5 to 10
million people get to die every year from kidney failure. With the limited data of the
epidemiology, rampant limited access to lab services, and the general lack of awareness, it is
evident that such numbers are even underestimated if true GBD for kidney disease is considered.
Besides, 19 million people were globally reflected on the 1990 DALYS due to kidney
disease. This number had increased to 33 million by 2013 (Murray et al., 2015). The DALYs that
were related to CKD, diabetes, heart diseases, cancers, and neurological had reflected a
significant increase between 1990 and 2015. The GBD 2016 report highlighted a relevant focus
omission on CKD where it had suggested that the SDG agenda does offer at its best the minimal
platform that draws attention to the health care proceedings and the monitoring needs of CKD
(Naghavi et al., 2017).
Kidney disease raises a heavy economic burden (Luyckx et al., 2018). For instance, it is
attributable to high national expenditures of 2 to 3% among the developed countries. These
countries spend the percentage budget annually for treatment of ESKD, even though the number
of people that are on plan to receive the treatment represent less than 0.03% of their total
population. Around 2.62 million people globally had received dialysis treatment in 2010 as the
dialysis treatment need got projected to be twice by 2030. Besides, the total global cost for the
treatment of the milder forms of CKD have proven to be more than the total treatment cost of the
end-stage kidney disease (ESKD). For example, the United States in 2015 had set aside Medicare
expenditures on CKD and ESKD that were over $64 billion and $34 billion respectively
(Matsushita et al., 2012). Whereas, much of this expenditure also entangles morbidity and
mortality that were previously attributed to hypertension and diabetes are also associated with
CKD and its complications (Luyckx et al., 2018).
The approach to CKD intervention globally is required to change from the end-stage
kidney disease treatment process to an intensive prevention regime both primary and secondary
in terms of occurrence and application (El Nahas & Bello, 2005). While, it is determined that
Africa is the second largest continent in the world, it is now faced with a dual challenge of
chronic diseases and infectious illnesses amidst its higher population of over 1 billion (for
instance, 961.5 million in sub-Saharan Africa while 195 million in the Northern part of Africa).
However, the burden of chronic disease in Africa is a secondary source to various factors, like
poverty, urbanization, increased life expectancy, globalization, and the changing lifestyle
practices (Ad-G, 2010).
The World Health Assembly had advocated for a Global Action Plan to prevent and
control the Non-Communicable Diseases between 2013 and 2020. Its primary target was and
remains to reduce the high rates of premature mortality to 25%, especially ones caused by the
chronic diseases from chronic diseases, by 2025. These actions plan are potent to making a
significant impact on the CKD burden (World Health Organization, 2013). But, the challenge of
the CKD has remained an underestimated and misunderstood ailment on the entire continent
because the continent is characterized with a lack of epidemiological information seen in
different countries in Africa (Abd et al., 2018).
Worldwide, the important risk factors associated with CKD are the HIV infection,
malaria, diarrheal chronic diseases, low birth weight, and the preterm births (Hill et al., 2016).
All of these conditions are among the leading causes of DALYs as noted by Luyckx et al.
(2018). Risks of CKD are the determinants of the environmental and life-course, and lifestyle
and infection etiologies. If these risk factors get identified earlier, the AKI and CKD can be
easily prevented and on earlier identification, diagnosis can be determined earlier, hence kidney
worsening can be slowed and expensive interventions can eventually be averted. If the world
advocates for a multi-sectorial approach as the primary means that can ensure achievement of
SDGs, it will be very possible to alleviate this incidence of CKD (Luyckx et al., 2018).
1.1.4 The CKD Prevalence and Economic Burden on the Developed Countries
The developed countries feel a greater burden of CKD with its prevalence and economic
parameters. For instance, the costs and outcomes related to CKD have been associated the
varieties of its stages that are different. From the perspective of the health system, the transition
CKD stages from the third stage to fourth and fifth is equivalent to 1.3 to 4.2 times increase in
budgeted costs. But in consideration of a higher cost is ESRD (end-stage renal disease) that sums
its required costs of intervention to between $20,110 and $100,593 (Elshahat et al., 2020).
Elshahat et al. (2020) elucidated that the progression of CKD from stages 1–3 to stages
4–5 was proximally associated with a corresponding reduction of 8–11% in the mean EQ-5D
index scores, whereas stages 4–5 of CKD had demonstrated the lowest scores of between 0.74
and 0.79). Complementing this scenario were some recent studies of life expectancy associating
the different stages of CKD across different countries that were limited in number and scope.
Amongst treatment modalities, kidney transplantations reflected the lowest costs of between
$14,067 and $80,876, with the highest EQ-5D scores of 0.82 – 0.83. While, the longest life
expectancy was reflected among the females and males across all age groups. (In all above
paragraphs, you need to use quotation marks around the words not your own and you need to
provide specific page numbers for the citations.)
1.1.4 The Thesis Reflection
The current chronic diseases are a thorn in the flesh. Studies delving on them need to take
another approach to strategize how to curb the disease. One problem associated with the high
insensitivity level and lack of proper interventions are on one side linked with the knowledge on
platform. Even though studies have elaborated on the seriousness of the disease, they have still
failed their course to elevate the mission to address the chronic diseases. The same applies with
CKD prevalence among the developed countries. It has been weighed on certain ethnic origins
but the disease is generally biting.
The dire need to tame the renal failure conditions in the major populations of the
developed, it must be determined to what degree does the CKD condition affect the developed
countries. As well, factors that catalyzes the CKD condition to induce the situation of economic
burden in the developed countries need to be determined to establish the course for the next
mission. Therefore, this study is to determine the degree and factors of Economic Burden Caused
by the CKD Condition among the populations of the Developed Countries
1.2 Problem Statement
The rate at which chronic diseases are becoming apparent is alarming. Every time there is
caution, and there is a plague chewing through a population. The developed countries have been
on the farthest end of receiving the dilemma cases for the chronic kidney disease patients. Most
people identified to be more susceptible are the Hispanic Americans, the African Americans, and
Indians, among others. But rather, what does it present on a platform for the countries where they
are residents and citizens. These countries are running stiffer economic races instigated by the
CKD. Then, high death rates are a scare to any developed country, and it may as well mean
running low on economic dynamicity when the population goes low.
There is one determination that can change the pattern and the trend of events: knowledge
on the degree and factors initiating the economic burden as far as the CKD is concerned. Even
though the CKD is a disease affecting a larger population of the developed countries, it is well
noted that aged people are more susceptible to the CKD patterns. This means that age is one of
the major factors that determines the economic burden, as well as the individual person’s
financial capability. For instance, a patient on CKD who is well off and able to pay for his
treatments presents a lesser burden to the state’s resources while those less privileged, for which
most of them are the ethnic races/groups edged in the developed society, tend to pose a heavy
burden on the government to cater for their longevity. The amount the government gets to
allocate portrays the degree of the burden imposed on the country.
Therefore, it is essential that the burden of CKD is established in order to know the
capacity that it holds on the economic segment of the developed countries. Further, determining
the factors that either elevate or reduce the number of the CKD patients and the capacity of
burden can help the governments of those states to restructure well and dedicate their focus for a
win-win situation, involving kicking out CKD through sufficient treatment plans or better
regimens covering a large population of affected people.
1.3 Objectives
1.3.1 Main Objective
To determine the degree and factors of economic burden caused by the chronic kidney disease
condition in the developed countries
1.3.2 Specific Objectives
To assess the statistics of the CKD people in the developed countries
To examine the primary factors causing CKD to prevail among the developed countries
To examine how a larger population of CKD patients influence the national budgets of
the developed countries.
To identify the major success or failures of the developed countries while dealing with
1.4 Hypothesis
H0: Developed countries do not have well treatment plans for CKD and strains its
resources more to cater for the associated patients.
H1: Developed countries have well-treatment plans for CKD and does not strain on its
resources to cater for the associated patients.
1.5 Justification
The developed countries like the U.S., Germany, Spain, and Portugal among others have
for long time being in the business of taming CKD. They have well devised strategies to manage
CKD epidemics among its populations, which essentially depends on a reliable assessment of
this burden. Besides, reliable assessments can also be vital for establishing an early detection
program as well as its affordability. The rationale for this is that, when the major problem
associated with CKD is established, these countries can have their perfect way in dealing the
epidemic toward a free-burdened population.
Secondly, previous studies have reported the CKD prevalence among the general
population of the developed countries. While, they determine that the specific prevalence of the
CKD condition is basically tied to secondary drivers of renal damage that includes diabetes
mellitus and high blood pressures. Their estimates have recorded a greater variation across
studies attributed to differences in the methods of measurement for glomerular filtration rate
(GFR), demographic characteristics (for example, age and gender), and/or background risks (in
terms of general population versus high-risk groups).
With a better determination of the degree and factors of economic burden with regard to
CKD, the developed countries can lay affordable and smart plans that can see their countries past
the window period framed. Every country seeks to spend less on diseases to allocate the funds
for another development project such as infrastructure or availing job opportunities, but with a
course to still curb an epidemic, it portends a difficult situation (or rather a threat) that deviates
the developmental plans. Therefore, this study is a framework to define the developed countries
structure of maneuver away from the burden of CKD through a convenience budget, working
regimens, reformed centers for dialysis, early detection programs to offer prevention rather than
curing plans, and the associated aided health care support to foresee interventions for CKD that
are long-term efficient.
1.6 Conceptual Framework (Defining the Study’s Components)
assessment to define
data and factors
and Failure
Awareness and
2.0 Literature Review
2.1 Definition, Reflector Statistics, and Classification of the Kidney Diseases
2.1.1 Review of the Kidney Disease
The kidney diseases have for long existed across history. The only difference today is
that many people have been put down with its accelerated occurrence. The global population is
no longer safe to enjoy the life health and wealth, but they have been dragged along pangs of
pain of the chronic diseases, kidney disease being the chief of them all. Globally, people of ages
between 65 and 74 years are estimated to have CKD for one out of every five men and one out of
four women ratios (World Kidney Day, 2015). It is estimated that the elderly are the most
affected groups across ages due to less metabolism functions and general asymptomatic
The kidney disease is simply the damage effect on human’s kidney that is also referred to
as a range of abnormalities seen from a direct clinical assessment (KDIGO, 2013). The acute
kidney disease (AKD) is not definable because it overlaps between numbers of conditions that do
not appear to have an evidence for a precise recognition. It may not be defined from the
sensitivity or specificity causal factor but it is largely or broadly induced by the reduced
functioning of the kidney. In cases where the kidney disease goes chronic, most functions of
excretion, metabolism, and endocrine reduce by the bouts of impairment. A substantial damage
increases the whole body’s absorption and assimilation failure to slow down the metabolism
Non-communicable diseases like diabetes, heart and kidney diseases have today been
seen replacing communicable diseases like malaria, influenza, and AIDs) to a greater extent with
greater repercussions (including premature deaths) across the world. Yet, approximately 80% of
this burden has occurred among the low- and middle-income countries, whereas 25% are people
younger than 60 years (Couser et al., 2011). From the topical projection, CKD is elevated and the
world is on crisis. For example, the World Health Organization reported that in 2005, around 58
million people died worldwide with 35 million succumbing as a result of chronic diseases (Levey
et al., 2007). Apparently, CKD can be treated, and with an early diagnosis and treatment, it is
even more possible to stop or slow the increasing kidney failure progression.
The measure used to categorize or classify the kidney disease is the Glomerular Filtration
Rate (GFR). GFR is the best overall index to determine the rate at which kidney functions.
Mostly, the GFR below 60 ml/min/1.73m2 is classified as decreased GFR, while below 15
ml/min/1.73m2 is classified as the kidney failure. The acute kidney infection quickens kidney
failure as an impact of chronic kidney disease (CKD).
Complications involved in the CKD are such as endocrine and metabolic associated, drug
toxicity, and high risks of getting cardiovascular diseases, among others. The patients are
vulnerable, also, to cognitive impairments, frailty, and infections from any source. There is
increased rate of developing other complications like hypertension, diabetes, and other noncommunicable diseases. In other cases, the occurrence of these conditions may be vice versa,
that is, the conditions may be ones initiating the chronic kidney disease. These complications
have a tendency of steepening ill-health to the point leading to death even without development
stage of kidney failure (KDIGO, 2013). As well, it should be noted that at times interventions
provided to treat or prevent the CKD and its associated comorbidity can cause such adverse
effects leading to a more sickly condition.
2.1.2 Criteria to Classify the Kidney Disease
Kidney diseases are either acute or chronic by classification. In the period of occurrence
and persistency, kidney disease is defined. For instance, chronic kidney disease occurs and is
named after a duration of 490 days (KDIGO, 2013). The rationale for this chronic level is based
on symptomatic and conditional differentials between the acute kidney diseases and the chronic
kidney diseases. These differences include AKI that calls for specific interventions depending
on level and grade or the etiological aspects and their outcomes. So, acute kidney disease is just
an early and abrupt kidney-associated symptomatic condition that may be treated to non-existent
or can progress to the chronic stage where infection, illness rate, and impairment is more serious.
As the conditional differences are determined, the accurate evaluation and regimen
focuses on the duration of the kidney disease which get documented or inferred in clinical
context. This is why the kidney patients are treated based on their medical history as regards to
what regimen has been given or not to initiate what kind of relief or further symptoms. For
example, the patient diagnosed of decreased kidney function that experiences or is in the middle
of an appearing acute illness is directly labelled as an AKI patient because the documentation for
his or her previous medical history is missing. Therefore, it means that the resolution for the
number of days of the clinical assessment would positively reflect an AKI diagnosis (KDIGO,
2013). Whereas, the patient experiencing same but does not have an acute illness gets inferred as
positive for CKD. So, if they are followed over time on clinical and biochemical assessment,
they would be confirmed positive for CKD.
In both of the above cases, it is recommended that the assessment of the kidney function
and damage be repeated for a more accurate diagnosis. Diagnosing kidney disease should not be
a one trial or test activity but repetition of the process makes sure that the diagnosis is the
accurate one for an appropriate intervention. The clinical judgment sets the platform for all the
clinical procedures to follow for suspecting the existence of a kidney disease. This is achieved by
timing the evaluation through the established clinical judgment that repositions an earlier
assessment for the AKI-suspected patients, then later assessment for the CKD-suspected patients
(KDIGO, 2013). In all cases, the diagnosis is determined, labelled, and put on an intervention
plan to alleviate the pain or stop infections.
2.2 Global Facts about the Kidney Disease
The global statistics indicate that about 10% of the population has been construed by the
chronic kidney disease (CKD), as millions die every year due to inaccessibility to affordable
treatments and regimens (World Kidney Day, 2015). Based on the 2010 Global Burden of
Disease research, CKD was ranked the 27th in the list among diseases that cause intensive
number of deaths across the world in the 1990. In the 2010 year, its prevalence causing deaths
had risen up the rank from 27th rank to the 18th. The extent of this shift up the list was, however,
rated second to the HIV and AIDs prevalence and number of deaths caused (Jha et al., 2013).
Currently, over 2 million people around the world are receiving a treatment plan associated with
dialysis. While a good number have either gone for kidney transplant or are supposed to undergo
the kidney transplant to be alive and functioning, but it represents only 10% of people that need
the dialysis or other treatment plans (Couser et al., 2011). Besides, out of the 2 million people
placed on kidney failure intervention plan, five countries have been successful to treat the failure
cases more efficiently. Among the countries are Italy, Brazil, the United States, and Japan. Other
countries are experiencing numerous hiccups while trying to set up the proper intervention for
the kidney failure patients. But today, more has been achieved in establishing structures for
treatments and protocols in the face of increased deaths caused by CKD.
Italy, Brazil, the United States, and Japan represent approximately 12% of the world
population, meaning that 88% are yet unaccounted for with regard to testing positive for CKD.
But, statistics reflect that only 20% get treated in the developing countries, say 100 of these
countries, and this make up for over 50% population across the globe (Couser et al., 2011).
Furthermore, over 80% of all the CKD patients receiving their treatment plan are in affluent
countries that have universal access to health care but with large elderly populations (Jha et al.,
2013). While, the number of kidney failure cases is still estimated to rise disproportionately in
the developing countries such as India and China that shows an acute increase in the number of
the elderly people.
On the other side are the middle countries whose treatment plans for dialysis or the
kidney transplantation process (Bicalho et al., 2018) has created heavy financial burdens for
most people diagnosed of CKD that have the dire need for the interventions. Also, for other
countries, around 112 in number, many people have failed to afford this kind of treatment and
the situation has resulted to the death of more than one million people annually due to untreated
kidney failure (Couser et al., 2011). The US, as the best strategist for CKD treatment plans, has
on its side set over $48 billion per year as the budget to help cater for relief and additional
lifespan of the in-question patients. This budget has been set with regard to the seriousness of the
CKD prevalence, and has received a lot of attention to maintain or save the number that if on
perishing by the disease, would otherwise reduce the dynamicity of the country. Reflecting on
this budget for the US, the treatment plan budget for the kidney failures takes about 6.7% of the
total budget for Medicare on an intervention care covering less than 1% population of the
country (World Kidney Day, 2015).
In China, it is estimated that in the next decade its economy will spend about $558 billion
due to impacts of death and disability inducted by cardiovascular and renal diseases (World
Kidney Day, 2015). The Uruguay situation is also related. Its annual cost for conducting dialysis
is about $23 million, which represents 30% of the National Resources Fund budget, especially
for the specialized therapies. In England, CKD consumes more of the expenditure cost than the
lung, breast, skin, and colon cancers if combined. This elucidation was based on the report
recently published by the NHS Kidney Care. Australia has treatment plans for both the previous
and current kidney failure cases, which is estimated to cost around $12 billion.
2.3 Economic Aspects of CKD
2.3.1 The Increasing Health & Economic Burden of Kidney Disease (The America’s Case)
It is approximated that 26 million Americans portray positive signs of chronic kidney
disease and are at a higher risk of developing kidney failure (The American Society of
Nephrology). While, another 20 million are vulnerable to developing and dying from kidney
disease. This number diagnosed with CKD has risen by a double factor for the last two decades.
Although this get to occur at any age, the elderly are more vulnerable to CKD. As the individuals
enter 60 years, kidney disease potency is viable, and manifests with complicated conditions.
With the progression of CKD, there is a possibility of kidney failure or the end stage
renal disease (ESRD) developing. The current statistics reflect that about 485,000 Americans
have been diagnosed with the kidney disease. All diagnosed have essential needs to an ongoing
expensive but life-changing interventional treatments like an all-time dialysis treatments, or even
kidney transplantation for them to increase their life span. The U.S. current annual budget for
treating ESRD is estimated to be more than $32 billion. While in this scenario, it is still expected
that many Americans with this advanced stage of CKD can increase to 785,000 by the end of
2020. With respect to that, the annual costs for treatment of the kidney diseases are estimated to
increase also to more than America’s one quarter (27.6%) of Medicare’s expenditures. It might
also increase beyond that afterward as result of the corresponding increase of CKD cases (The
American Society of Nephrology). While these expenditures are exuberant, many patients have
failed to receive appropr